Development of a Secondary Order Program for Pretransfusion Tests to Improve the Work Efficiency of Blood Bank

Jung-ah Kim, J. Shin, Do Lee Lee, W. Shin, Jieun Kim, H. I. Bang
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Abstract

blood bank, if the Ab screening test results are positive in the pretransfusion test, an Ab identification test and polyspecific direct antiglobulin test (DAT) are performed. IgG and C3 monospecific DATs are also performed if the polyspecific DAT is positive. To perform additional tests, clinical technologists used to communicate with the clinical department by telephone, and then the clinical doctor issued the orders. There could be problems with this process, such as clerical errors and reduced work efficiency. Therefore, this study developed the secondary order program to improve the work efficiency of the blood bank. Methods: The secondary order program that allows the laboratory medicine doctors to issue additional test orders, print out barcodes in blood bank, and immediately report the results to the EMR (Electronic Medical Record) was developed. Before (Jul 2018 ∼ Jun 2019) and after (Jul 2019 ∼ Jun 2020) applying the program to inpatients, the number of telephone calls, Ab screening tests, Ab identification tests, polyspecific DAT, and monospecific DAT were compared to evaluate the effectiveness of the program. Results: After applying the program, 515 calls per year (average 43 calls per month) were reduced. Before the program, the results of 68 Ab screening tests and 16 polyspecific DATs were not reported on EMR, but no case was missed after the program. Conclusion: Through the secondary order program, the work efficiency of the blood bank was improved. It is expected that expanding this program to other blood bank tests will help implement tests faster and make them more systematic. (Korean J Blood Transfus 2021;32:22-27)
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制定二级输血前检测方案,提高血库工作效率
如果在输血前试验中Ab筛选试验结果为阳性,则进行Ab鉴定试验和多特异性直接抗球蛋白试验(DAT)。如果多特异性DAT阳性,也进行IgG和C3单特异性DAT检测。为了进行额外的检查,临床技术人员通常通过电话与临床部门沟通,然后由临床医生发出命令。这个过程可能会有问题,比如文书错误和工作效率降低。因此,本研究开发二级程序,以提高血库的工作效率。方法:开发二级指令程序,允许检验医学医生发出附加检测指令,在血库中打印条形码,并立即将结果报告给电子病历。在将该方案应用于住院患者之前(2018年7月~ 2019年6月)和之后(2019年7月~ 2020年6月),比较了电话次数、抗体筛选试验、抗体鉴定试验、多特异性DAT和单特异性DAT,以评估该方案的有效性。结果:应用该方案后,每年减少515个电话(平均每月43个电话)。项目实施前,有68例Ab筛选试验和16例多特异性dat未在EMR上报告结果,但项目实施后没有遗漏病例。结论:通过二级排序程序,提高了血库的工作效率。预计将这一项目扩展到其他血库测试将有助于更快地实施测试并使其更加系统化。(韩国J输血2021;32:22-27)
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